Rajneesh K Joshi1, Sanjay M Mehendale2. 1. Department of Epidemiology and Biostatistics, National AIDS Research Institute (ICMR), 73, 'G'-Block MIDC Bhosari, Pune - 411026, Maharashtra, India Faculty of Health and Biomedical Sciences, Symbiosis International University , Pune, Maharashtra, India rajneeshjoshi@yahoo.com. 2. National Institute of Epidemiology, R 127, 3rd Avenue, TNHB, Ayapakkam, Chennai, Tamil Nadu - 600077, India.
Abstract
BACKGROUND: Estimates of HIV burden in India are based on HIV sentinel surveillance (HSS), which has limitations such as insufficient sample size for district level analysis and ethical concerns. We analysed prevention of parent-to-child transmission (PPTCT) program data, for its suitability for HIV surveillance in India. METHODS: Correlation and differences in ante-natal clinic (ANC) attendees' HIV prevalence from the last four rounds of HSS (2007-2012) and PPTCT data for the corresponding years were analysed at national, state and district levels. Sensitivity and region wise analysis were also done. RESULTS: The PPTCT program covered a higher number of districts and ANC attendees than HSS. Correlation of HIV prevalence from PPTCT data with HSS was high (0.99) at national level, moderate (0.66-0.86) at state level, and low (0.43-0.62) at district level. HIV prevalence levels from HSS were generally higher than those from PPTCT data. As the coverage of PPTCT program and HSS improved, the differences between HIV prevalence from these two data sources increased. Sensitivity analysis showed significant differences in ANC attendees' HIV prevalence from HSS and PPTCT, even among districts with high HIV test uptake level in PPTCT program. CONCLUSIONS: PPTCT program data can be utilised for HIV surveillance in India as it has better coverage and will avoid ethical issues and expenditures related to HSS.
BACKGROUND: Estimates of HIV burden in India are based on HIV sentinel surveillance (HSS), which has limitations such as insufficient sample size for district level analysis and ethical concerns. We analysed prevention of parent-to-child transmission (PPTCT) program data, for its suitability for HIV surveillance in India. METHODS: Correlation and differences in ante-natal clinic (ANC) attendees' HIV prevalence from the last four rounds of HSS (2007-2012) and PPTCT data for the corresponding years were analysed at national, state and district levels. Sensitivity and region wise analysis were also done. RESULTS: The PPTCT program covered a higher number of districts and ANC attendees than HSS. Correlation of HIV prevalence from PPTCT data with HSS was high (0.99) at national level, moderate (0.66-0.86) at state level, and low (0.43-0.62) at district level. HIV prevalence levels from HSS were generally higher than those from PPTCT data. As the coverage of PPTCT program and HSS improved, the differences between HIV prevalence from these two data sources increased. Sensitivity analysis showed significant differences in ANC attendees' HIV prevalence from HSS and PPTCT, even among districts with high HIV test uptake level in PPTCT program. CONCLUSIONS: PPTCT program data can be utilised for HIV surveillance in India as it has better coverage and will avoid ethical issues and expenditures related to HSS.
Keywords:
HIV; HIV sentinel surveillance (HSS); India; Prevention of mother-to-child transmission of HIV (PMTCT); Prevention of parent-to-child transmission of HIV (PPTCT)
Authors: Jacob Dee; Jesus M Garcia Calleja; Kimberly Marsh; Irum Zaidi; Christopher Murrill; Mahesh Swaminathan Journal: JMIR Public Health Surveill Date: 2017-12-05